EP0373011B1

EP0373011B1 - Femoral hip prosthesis

Info

Publication number: EP0373011B1
Application number: EP89403020A
Authority: EP
Inventors: Christian Nourissat; Alain Gueret; José Adrey; Christian Goalard; Daniel Berteaux; Georges Hamon
Original assignee: Benoist Girard et Cie SAS
Current assignee: ADREY, JOSE; BERTEAUX, DANIEL; Goalard Christian; Gueret Alain; HAMON, GEORGES; Nourissat Christian; Benoist Girard et Cie SAS
Priority date: 1988-11-02
Filing date: 1989-11-02
Publication date: 1994-01-19
Anticipated expiration: 2009-11-02
Also published as: ES2050832T3; DE68912541T2; DE8912977U1; JPH02198548A; US5139522A; CA2002136A1; DE68912541D1; FR2638351A1; IE893512L; ATE100304T1; CA2002136C; IE64125B1; EP0373011A1

Abstract

A hip joint femoral prosthesis has a rod (2), the proximal end (6) of which has a cross-section of oval shape and a surface area increasing towards the proximal end. At least one wall of the proximal end includes alveoli (9) therein hollowed out so as to present a maximum depth on their side towards the proximal end. The alveoli are of a circular or semi-circular shape and intersect, thereby providing a surface which improves the stability and anchoring of the prosthesis into the femur.

Description

This invention relates to a hip joint femoral prosthesis. More particularly, it relates to a prosthesis having fish scale depressions on the proximal end to enhance fixation after implantation, in a non-cemented hip.
Femoral hip joint prostheses which have at their distal end a rod to be inserted into the femur medullary canal, and at the other end a neck made integral with an element for accommodating a femur head of spherical shape, are well known. Such prostheses have a shape to facilitate their introduction and positioning into a femoral intramedullary canal which has been previously reamed out by a surgeon. These prostheses must possess an outer surface permitting efficient regrowth of the bone tissue.Finally, the prosthesis must, as much as possible, be easily removable without causing any additional damage to the femur since, obviously, the femur is already damaged to an extent requiring implantation of such a prosthesis.
In order for the femoral components to possess all of these properties, some of which are contradictory, it has already been proposed to give the rods a rectilinear shape or a shape presenting various curvatures with a circular or oval cross-section. These components may have a terminal angle that facilitates the introduction into, or the removal from the femur. These rods may also have flutes or serrations present at their periphery to permit better ingrowth of bone tissue ; or they may even be coated with a coating layer known to be resorbed in the blood medium such as a hydroxyapatite layer.
However, a femoral component having such a coating thereon, which coating dissolves with time in the bone tissue, has a disadvantage. Due to dissolution of the coating, these components have a tendency to be driven more deeply into the femur. Such a displacement of the prosthesis with respect to the femur or bone in which it is implanted works against the firm anchoring of the latter in the canal.
It has been attemoted to remedy this disadvantage by providing, on the walls of the proximal end of the femoral component, raised portions resisting any lowering of the prosthesis into the femur. In particular, these projections may be in the form of ladder steps or horizontal serrations. However, these projections are not entirely satisfactory because, as the area on which they might be made is limited, they fulfill their function only imperfectly.
For instance, EP-A-106-945 is disclosing an anchoring shank of rectangular cross-section for a femur prosthesis which is provided, along its whole length, with a plurality of tapered depressions having a trough parallel to be axis of the shank, so as to improve the adhesion between the bone cement bed and the shank and obviate looseness caused by shrinkage of the bone cement bed. A prosthesis according to the features of the preamble of Claim 1 is known from EP-A-0 278 205.
The object of this invention is an improvement thereof which permits a more positive anchoring in the bone tissue.This object is achieved by hollowing out depressions or alveoli which exhibit a maximum depth on the proximal side and a minimum depth on the distal side of the rod. These depressions are located at the proximal end of the rod, i.e. the portion of the femoral implant located in the area of the extension of the center line of the neck. The cross-section in this area is of an oval shape. In this section of the component, the surface area increases with distance from the distal portion of the rod and the depressions are formed on at least one of the walls of this oval portion of the rod (usually posterior or anterior). Thus, the area covered by depressions also increases from the distal end to the proximal end of the femoral component.
The cementless implantable hip joint femoral prosthesis according to the present invention comprises at the distal end a rod for insertion into the femur medullar canal and at its other end a neck made integral with an element for accommodating a head of spherical form thereon, the cross-section in the area of the proximal end (6) of the rod, which is of an oval shape, increasing with the distance from the distal end (5) of the rod, and it is characterized in that at least one of the walls of said proximal portion (6) of the rod comprises alveoli (9) formed thereon, so as to increase the area of the prosthesis in contact with the bone tissue, said alveoli hollowed out so as to present a maximum depth on the proximal end and a minimum depth on the distal end and to form an angle between the hip wall and the alveolus bottom, said aveoli (9) having practically circular or semi-circular shape and being distributed in rows, preferably in such a close relationship that their circular peripheries intersect and give the so alveolated wall the aspect of fish scales.
These alveoli are practically circular or semi-circular in shape. They may be disposed in staggered rows of both circular or semi-circular depressions, which may be sufficiently close to one another so that their peripheries intersect and give their aspect of fish scales to the so textured surface.
The alveoli or depressions are preferably formed on both the forward (anterior) and rearward (posterior) walls of the proximal portion of the femoral component, since these walls correspond to those sides of that oval portion of the rod which present, in cross-section, the largest radii of curvature, thus offering the largest lateral surface area. These alveoli may also be formed on the inner or medial wall of the proximal portion of the oval cross-section of the rod.
It is to be noted that the shape of this proximal portion of the rod, i.e. with the oval cross-section having a surface area increasing towards the neck, has the obvious advantage of increasing the lateral surface area of the wall or walls to be covered with alveoli. The shape of this area can be combined with the very shape of the alveoli to place the maximum number thereof on the so offered lateral surface to thus obtain maximum support for the prosthesis in the femur. Such an alveolar structure does not in any manner affect the positioning of the prosthesis in sofar as its lodging was previously provided for in the medullar femur canal by the reaming step.
The structure is such as to provide a stable load distribution over all of a significant surface area for support in the bone once the prosthesis has been finally positioned. Therefore, it permits fixation thereof which is such as to resist and limit, in a natural manner, the driving down or the rotation of the prosthesis into the medullar canal. The semi-circular or circular shape of the alveoli, in particular the whole of the edge portions comprises therein, increases the stability of the prosthesis due to a better distribution of the forces over large lateral surfaces. The very shape of these depressions also has the advantage of being totally compatible with easy removal of the prosthesis.
In addition to these purely mechanical advantages, the alveoli or depressions formed in the walls of the implant increase the area of the prosthesis in contact with the bone tissue, while leaving such a volume as is necessary for bone regrowth. The alveoli also have the advantage for favoring the reconstitution of the bone tissue, thereby also providing for stability and fixation of the prosthesis into the femur.
Finally, the shape of the alveoli of the present invention is particularly favorable to permit accommodation and adherence of a hydroxyapatite coating which increases and stimulates the osteo-conductive characteristics of the implant.
This invention will mow be described with reference to the attached drawings in which :

Figure 1 represents a side view of a first embodiment of a prosthesis according to the invention ;
Figures 2 to 4 represent cross-sectional views according to lines A-A, B-B and C-C respectively of Figure 1 ;
Figure 5 represents on a much larger scale, a view in relief of the alveoli of the first form of embodiment ;
Figure 6 represents a side view of a second embodiment of a prosthesis according to the invention ; and
Figure 7 represents a lateral view of a third embodiment of the invention.

Referring to Figures 1-5, the prosthesis (generally denoted as 1) comprises a rod or femoral component 2 of elongated shape connected in the intertrochanterian zone to a neck 3 made integral with an element 4 for receiving thereon a femoral head of spherical shape (not shown).
Rod 2 comprises a relatively elongated distal end 5 of circular cross-section as illustrated in Figure 4, and a relatively short proximal end 6 of oval cross-section, the surface area of which increases towards its proximal end as shown in Figures 2 and 3, i.e. as it comes closer to the intertrochanterian zone shown in Figure 1 by line 7.
The portion of the rod 2 between the intertrochanterian zone 7 and the zone 8 connecting the oval and circular cross-sections constitutes the proximal end 6 of the rod. End 6 is located in the extension of the center line of the prosthesis neck.
According to the present invention, this portion of the rod called proximal end 6 is to be covered with alveoli or depressions. According to a first form of embodiment shown in Figures 1-5, the forward and rearward lateral walls of such end 6 of the rod include the alveoli thereon.
Such alveoli, in the shape of the embodiment shown in Figures 1-5, have a circular shape and are distributed in staggered rows on the surface of these two walls in the form of tangent or intersecting circles. As shown schematically in Figure 5, the alveoli 9 are formed by hollowing out or cutting planar circular cavities such that the depth of the cavities is maximum on the proximal side of the center line of the rod and absent or flush on the opposite (distal) side.
The prosthesis shown in Figure 6 differs from that shown in Figures 1-5 in that the alveoli are practically semi-circular and so close to one another that their circular peripheries intersect to a predetermined extent, thus giving the aspect of fish scales thereto. The prosthesis of Figure 7 differs from the form of embodiment of Figure 6 by the application of a hydroxyapatite coating shown by the cross-hatched area 10 on all the alveolated portions 6 of the rod. This same Figure 7 also shows that not only the forward and the rearward walls, but also the inner medial wall of the proximal end 6 of the femoral component may include alveoli thereon.
The various prostheses according to the invention can be easily manufactured with the alveolated wall(s) integrally formed thereon. The alveolated prostheses, so obtained in rough from forging, can then be covered with a hydroxyapatite layer. All the alveoli of the alveolated wall(s) of one and the same prosthesis have preferably the same dimensions.
As mentioned previously, the alveoli or depressions according to the invention are preferably of a practically circular or semi-circular shape. The alveolus diameter is in view of the usual dimensions of the femoral prostheses, generally comprised between 3 and 7 mm, preferably 5 mm. The maximum hollowed out depth of the alveolus or depressions in the proximal end of the rod is generally between 0,3 and 0,7 mm, preferably 0,5 mm. The angle included between the normal directions to the wall and the plane of the circular bottom of an alveolus or depression is generally comprised between 5 and 20°, preferably between 10 and 15°.
Alveoli with these dimensional characteristics have shown to be satisfactory on femoral prostheses having a lenght of the alveolated portion of the rod as measured along the center line of the neck between 2 and 5 cm.
While several examples of the present invention have been described, it is obvious that many changes and modifications may be made thereunto, without departing the scope of the invention as expressed in the claims.

Claims

A cementless implantable hip joint femoral prosthesis (1) comprising at its distal end a rod (2) for insertion into the femur medullar canal and at its other end a neck (3) made integral with an element (4) for accommodating a head of spherical form thereon, the cross-section in the area of the proximal end (6) of the rod, which is of an oval shape, increasing with the distance from the distal end (5) of the rod, characterized in that at least one of the walls of said proximal portion (6) of the rod comprises alveoli (9) formed thereon, so as to increase the area of the prosthesis in contact with the bone tissue, said alveoli hollowed out so as to present a maximum depth on the proximal end and a minimum depth on the distal end and to form an angle between the hip wall and the alveolus bottom, said aveoli (9) having practically circular or semi-circular shape and being distributed in rows, preferably in such a close relationship that their circular peripheries intersect and give the so alveolated wall the aspect of fish scales.
A prosthesis according to Claim 1, characterized in that the alveolated wall(s) of the proximal portion (6) of the rod are the forward, rearward and the internal wall.
A prosthesis according to any one of the preceding claims, characterized in that the alveoli (9) are distributed in staggered rows on the alveolated wall(s).
A prosthesis according to Claim 1, characterized in that all the alveoli (9) of the alveolated wall(s) have the same dimensions.
A prosthesis according to Claim 1, characterized in that it is manufactured directly with its alveolated wall(s) and is thereafter coated on its alveolated portions with an outer coating of hydroxyapatite.
A prosthesis according to Claim 1, characterized in that the alveolated portion (6) of the rod is covered with an outer coating of hydroxyapatite.
A prosthesis according to Claim 1, characterized in that the alveoli (9) have a diameter of between 3 and 7 mm and extend into the wall to a maximum depth on their proximal end, said depth between 0,3 and 0, 7 mm, and in that the angle included between the normal directions to the wall and to the plane formed by the circular bottom of an alveolus is between 5 and 20°.
A prosthesis according to Claim 1, characterized in that the length of the alveolated portion (6) of the rod (2) as measured along the center line of the neck (3) is between 2 and 5 cm.